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Biomedical subjects

A Roussel

Publications and source records attributed to A Roussel.

At least 55 records · Page 3Linked to original sources
PubMed1988

Hemibody irradiation in stage III multiple myeloma: results of 20 patients.

The advanced forms of multiple myeloma of bone, stage III, or those with a large tumoral mass, characterized by a considerable number of myeloma-cells, pose difficult problems in treatment. Little progress has been made since the introduction of the alkylating agents, and combined chemotherapy does not seem to be any more effective in terms of survival. It is these severe forms that culminate in painful symptoms which are often difficult to eliminate. The radiosensitivity of myeloma led us to treat 20 patients affected by severe forms of the disease by total body irradiation in two stages, and we analyse here the effects of treatment and the tolerance for this technique.

Female↗
PubMed1987

[Radiation enteritis after pelvic irradiation of cancer of the rectum. Prevention by omentoplasty and pelvic partitioning with polyglactin 910 mesh].

To prevent radiation enteritis during post-operative irradiation of the pelvis for rectal carcinoma, the greater omentum, fed by the left gastro-epiploic pedicle, is pulled down into the pelvis which is separated from the abdomen by an absorbable polyglactin 910 mesh. The mesh, under tension, is attached superiorly to the lips of the posterior peritoneal section and anteriorly to the upper border of the pubis. This procedure has been used in seven patients, four of whom have been irradiated post-operatively without any gastrointestinal complication.

Enteritis↗
PubMed1986

[Intraoperative abdominopelvic radiotherapy by single dose electrons].

Thirty-four patients received, during laparotomy, a 15-20 Gy localized irradiation from a 10-13 MeV beam of electrons supplied by a linear accelerator and focalized by means of a localizer especially designed for this purpose. This technique is indicated for localized residual tumours of the pelvis and intra-operative irradiation of the lumbar aorta, as part of a chemo-radiotherapeutic programme in patients with advanced cancer of the cervix. It is too early to evaluate the medium-term results, but the technique is very well tolerated immediately.

Abdominal Neoplasms↗
PubMed1985

[Dual-chamber cardiac pacemakers. Hemodynamic value].

Dual chamber pacemakers have been designed to restore normal atrio-ventricular synchronism and maintain it during exercise. Progressive acceleration of the electrically stimulated heart rate provides "physiological" adaptation of cardiac output. In subjects with a normal heart, the atrial systole plays a relatively minor role (about 20% of the cardiac output at rest), and it is only in rare cases (e.g. pacemaker syndrome) that implanting a dual-chamber pacemaker becomes necessary. However, the atrial systole plays a much greater role in acute or chronic heart diseases, notably in patients with cardiac failure, mitral or tricuspid valve regurgitation or reduced cardiac compliance. Dual chamber pacemakers are more frequently required in such cases to correct or prevent the detrimental effects of normal atrio-ventricular synchronism, among which atrioventricular conduction is the worst tolerated.

Arrhythmias, Cardiac↗
PubMed1985

Nosocomial legionellosis, Paris, France. Evidence for transmission by potable water.

During a five-week period in 1981, six cases of legionellosis due to Legionella pneumophila serogroup 1 were recognized in a hospital in Paris, France. Four cases were clearly nosocomial in origin. There was a direct association between development of disease and exposure to potable hot water (p = 0.003). The entire hot water system was contaminated with L. pneumophila serogroup 1; monoclonal antibody testing demonstrated that the case isolate and the potable water isolates belonged to the same subgroup. Although serogroup 1 was isolated from both the cooling tower and its drift, the cooling tower isolate was antigenically distant from the case isolate. In other nosocomial outbreaks of legionellosis, multiple sources have been found within the hospital environment, but an epidemiologic association of disease with potable water had not been shown. The significant association of cases with exposure to the potable hot water supply, and the identification of case and potable water isolates of the same subtype, suggest that the potable hot water was responsible for transmission of disease in this outbreak.

Adult↗
PubMed1985

[Tricuspid insufficiency in biventricular myocardial infarct].

Tricuspid insufficiency (TI) has already been reported as a possible complication of biventricular infarction. However, in the absence of large study groups, this condition is not well known. This paper reports the results of 2 studies: a retrospective study of 91 biventricular infarcts, identified by haemodynamic criteria, and a prospective study of 23 consecutive patients (belonging to the previous group) in whom selective right ventricular cineangiography was performed in the acute phase. The following conclusions were drawn: moderate to severe TI is very common during the first days of infarction (30%/39%); the diagnosis is simple, based on non invasive, very sensitive (89%) and specific (100%) haemodynamic criteria; it is associated with a much more severe clinical and haemodynamic presentation and with a higher mortality in the acute phase (37% vs 6.2% in the global study); the poor prognosis does not persist in the long term; regression is common (2/3 to 3/4 of cases) and angiographic data suggests that it is often related to a transient ischaemic papillary muscle dysfunction. Acute paralysis of the right atrium may also play a major role; the TI remains unchanged only in rare cases and may then be responsible for a chronic right ventricular dysfunction and then raise the question of surgical intervention.

Adult↗
PubMed1984

[Multiple myeloma of the bones. Treatment by 2-stage whole-body irradiation. 7 cases].

Seven patients with high tumoral burden myeloma of bones were treated by two successive hemicorporeal irradiations. This treatment was strikingly effective in providing pain relief which was durable in 3 cases. It might also have reduced the tumoral mass, since partial remission was obtained in 2 cases and lasting normalization of calcaemia in one patient with a non-excreting myeloma. Its haematological side-effects did not seem to exceed those of combined chemotherapy, and its pulmonary toxicity was reduced by using corrected doses.

Aged↗
PubMed1984

[Hemodynamics and M mode echocardiography of the consequences of ventriculo-atrial conduction in the human].

A haemodynamic and M mode echocardiographic study of 57 patients hospitalised for chronic, symptomatic 2nd or 2rd degree AV block was carried out after 3 periods of pacing, each lasting 2 hours : 1) sequential AV pacing ( SAV ) with a 200 ms delay, considered as the mode of reference; 2) sequential ventriculo-atrial pacing ( SVA ) with the same sequential delay, recreating equivalent conditions of 1/1 ventriculo-atrial conduction (VAC); 3) ventricular pacing (V) recreating complete AV dissociation ( CAVD ). The pacing rate was the same for each patient (89 +/- 9/min). In comparison with SAV , SVA caused much worse haemodynamic changes than V : large increases in mean atrial pressures (+161% and +64% in RAP and PCP respectively); "canon" atrial A waves which were poorly tolerated (mean amplitude 14 mmHg and 18 mmHg on the RA and PCP waves respectively); in some cases, a large fall in blood pressure was observed due to the failure of systemic resistances to increase and compensate for the constant decrease in pump function (mean reduction of 23% of cardiac index; 29% of LV work index). These changes are much more pronounced in diseased than in healthy hearts, especially in the presence of mitral or tricuspid regurgitation. Echocardiography showed the main cause of these haemodynamic changes to be a reduction in ventricular filling with significant reductions in LV systolic and diastolic dimensions, changes in the mitral valve echos (reduction in the opening and closing velocities, delayed closure), probably related to a decrease in transvalvular blood flow, and decreased regional contractility of the interventricular septum. These observations justify an increase in the indications of modes of pacing maintaining permanent atrio-ventricular sequence (VVI pacing at slow rates; AAI pacing, DVI or DDD pacing in cases of abnormal AV conduction with VAC, especially in cases of sick sinus syndrome with permanent bradycardia). These modes of pacing are particularly beneficial when the electrical abnormality is associated with a decompensated cardiac lesion, or with decreased ventricular compliance or mitral regurgitation.

Adolescent↗
PubMed1983

[Bacteriological study of hands and the use of soap in the hospital environment].

Direct contact, especially by touching, is the most important route for the transmission of hospital infections. To examine this risk, we have investigated the frequency of bacteria present on the hands of the nursing staff on the long and medium stay wards of the Hospital Paul- Brousse in Villejuif. The study showed that the amount of bacteria after tending the patients before and after washing the hands with soap tablets is still far from negligible. Staphylococci were predominant both from the frequency and density of their cultures, the risks of transmitting the infection increased with the level of contamination. Although in far smaller amounts, enterobacteria were isolated, probably a sign of faecal contamination. Some of these organisms belonged to bacteria called "hospital infections", resistant to many types of antibiotics. The results point out the limitations of the present system for washing hands, in particular using soap tablets--the soap is a source of infection as it becomes soft when kept wet. Improvement could be achieved by instituting a few simple measures, such as rehabilitating mobile basin units using a scrubbing-brush, carefully drying the hands, using linen that is kept only for patients who have septic infections, issuing personal soap tablets or even better using liquid soap in disposable containers.

Cross Infection↗
PubMed1983

Substitution of aluminium hydroxide by high doses of calcium carbonate in patients on chronic haemodialysis: disappearance of hyperaluminaemia and equal control of hyperparathyroidism.

Al(OH)3 was discontinued in 26 patients on chronic haemodialysis as well as vitamin D metabolites in eight. Oral CaCO3 was progressively increased from 4 +/- 3 to 10 +/- 5g/d to keep plasma PO4 less than 6.0mg/dl and P Ca less than 10.5mg/dl. This treatment had to be discontinued in three cases because of diarrhoea and/or uncontrolled hyperphosphataemia. In the remaining patients the control of hyperphosphataemia and of PTH values was as good or even better. Hyperaluminaemia disappeared in most patients demonstrating the role of oral Al(OH)3 in the induction of hyperaluminaemia. Because of frequent transient hypercalcaemia and of the occurrence of vascular calcification in two patients, high doses of CaCO3 after discontinuation of Al(OH)3 are advised only in cases of hyperaluminaemia.

Aluminum↗